Inflammatory Biomarker Profiling in Preeclampsia: Identifying Predictive Biochemical Signatures in Pregnant Women in Abuja

Preeclampsia is a leading cause of maternal mortality in Nigeria, and identifying predictive inflammatory biomarker signatures in early pregnancy could enable earlier clinical intervention in high-risk women. This study profiles inflammatory biomarkers in preeclamptic women compared to normotensive pregnant controls at the National Hospital Abuja, with the aim of identifying early-trimester predictive signatures. A nested case-control study within a prospective cohort enrolled three hundred pregnant women from their first antenatal visit. Blood samples were archived from all participants at first, second, and third trimester visits. Sixty-two women who developed preeclampsia and one hundred and twenty-four matched normotensive controls were identified for case-control analysis at the end of the study. Archived samples were retrieved and analysed for high-sensitivity CRP, IL-6, IL-8, IL-10, TNF-alpha, interferon-gamma, soluble fms-like tyrosine kinase-1 (sFlt-1), and placental growth factor (PlGF) by multiplex immunoassay. Receiver operating characteristic analysis evaluated the predictive accuracy of first-trimester biomarkers for preeclampsia. Results show that first-trimester sFlt-1 and IL-6 were the strongest predictors of subsequent preeclampsia development, with sFlt-1 achieving an AUC of 0.81 and IL-6 an AUC of 0.77. The sFlt-1 to PlGF ratio at twelve weeks showed the highest predictive accuracy (AUC 0.87) for early-onset preeclampsia. Third-trimester CRP, sFlt-1, IL-6, and TNF-alpha were all significantly elevated, confirming established inflammatory activation at clinical diagnosis. A three-biomarker first-trimester predictive panel achieved 79 percent sensitivity and 82 percent specificity. Keywords: preeclampsia, inflammatory biomarkers, sFlt-1, predictive signatures, Abuja.